Hybrid simulation for knee arthrocentesis: improving fidelity in procedures training

Area of Science:

• Medical Education
• Simulation-based Learning
• Internal Medicine Residency Training

Background:

• Mastering procedural skills is crucial for internists, but residency programs often fall short.
• Existing simulation curricula frequently overlook essential communication skills for proficient procedure performance.
• Hybrid simulation (HS) offers an innovative, integrated approach to teaching and assessing procedural skills within a contextual framework.

Purpose of the Study:

• To develop and evaluate a hybrid simulation (HS) model for teaching arthrocentesis.
• To assess the efficacy of HS in enhancing both technical and communication skills for internal medicine residents.

Main Methods:

• A hybrid simulation (HS) model was implemented in an internal medicine residency program.
• Twenty-four second-year residents participated, receiving training and feedback from standardized patients (SPs) and faculty.
• Residents were assessed on procedural and communication skills using standardized scenarios and validated scoring measures.

Main Results:

• The HS model was highly rated for realism by residents, SPs, and physicians, enhancing perceived learning.
• Residents demonstrated procedural skills comparable to experienced trainees (PGY 2-3), with high interclass correlation (ICC = 0.77).
• The majority of residents achieved competency in arthrocentesis, indicating the model's effectiveness.

Conclusions:

• Hybrid simulation (HS) effectively integrates the simultaneous acquisition of technical and communication skills.
• HS shows promise as a valuable tool for improving procedural competency in internal medicine residents.
• Further research is warranted to investigate the transferability of skills learned through HS to clinical practice.